ability to achieve and sustain an erection depends on a complex
interaction of sensory information, nerves, blood vessels,
hormones and emotions. In particular, vascular tissue in the
penis needs to fill with blood after nerves have carried sexual
stimulation from the brain.
Regular failure to achieve an erection is called Erectile
Dysfunction or ED. Estimates of the
total number of American men who suffer from ED range from 15-30
million, according to the National Institutes of Health.
This stressful disorder is often linked to Insulin Resistance,
an imbalance in blood glucose and insulin levels associated with
excess weight and obesity. Being overweight can place extra
strain on the cardiovascular system and disrupt the delicate
balance required to achieve an erection and, therefore, cause
Essentially, Erectile Dysfunction occurs when the body
experiences a breakdown in the sequence of events that normally
leads to an erection. The disruption can occur in nerve impulses
to and from the brain, spine and penis or in the muscles, fibrous
tissues and arteries in or near the corpora cavernosa the two
parallel chambers of the penis that fill with blood to create
Erectile Dysfunction and Insulin Resistance
Excess insulin created by Insulin Resistance is implicated in ED
because it damages the endothelium of cardiovascular vessels.
The endothelium is the layer on the inside of the vessel which
secretes chemical mediators that instruct the vessel to contract
or relax. To achieve an erection, a release of nitric oxide from
the endothelium creates vascular dilation, which allows vessels
to fill with blood. This influx of blood is necessary to achieve
an erection. Any decrease in nitric oxide supply to the penis
caused by the insulin-damaged endothelium lessens or prevents
vascular dilation and contributes to erectile dysfunction.
Erectile Dysfunction is not the same as premature ejaculation, a
low sex drive or a low sperm count that results in male
infertility, though one or more of these conditions may
accompany ED. Occasional failure to achieve an erection (less
than 20% of the time) can occur for a variety of reasons - such
as drinking too much alcohol or extreme fatigue - and is not
considered unusual. But a failure rate of more than 50% during
the occasions when a man wants to have an erection usually
indicates a problem that requires treatment. Erectile
Dysfunction is much more common in older men - researchers
estimate that half of men over age 60 have ED.
If neglected, excess weight gain can also lead to other
conditions linked to ED like the cluster of increased risk
factors for cardiovascular disease called Metabolic Syndrome
(Syndrome X) as well as Pre-Diabetes, which, if neglected, can
lead to irreversible Type 2 Diabetes. Between 35-50% of men with
Diabetes experience ED because the disease can damage nerves and
arteries, making it difficult to achieve an erection.
However, major weight loss can be achieved can by reversing
Insulin Resistance, thus removing major factors in the onset of
A Complexity of Factors
A wide variety of physical and psychological conditions are
associated with ED. These include prostate surgery, depression,
stress, performance anxiety, kidney disease and hormonal
imbalances. Because of the complexity of factors in an erection,
ED can involve physical or psychological issues - or a
combination of the two.
As many as 70% of ED cases are caused by cardiovascular diseases
such as atherosclerosis. This disorder is a type of hardening of
the arteries in which cholesterol, fat and other blood
components build up in artery walls via poor diet and lack of
regular exercise resulting in excess weight gain.
As the condition progresses, the arteries to the heart may
narrow, reducing the flow of oxygen-rich blood and nutrients to
the heart and brain. This restriction can also reduce blood flow
to the tissues of the penis, causing ED.
Other excess weight and obesity-linked cardiovascular diseases
that can cause ED are hypertension (high blood pressure) and
high levels of triglycerides and LDL " bad" cholesterol in
combination with low levels of HDL "good" cholesterol all
factors in reversible Metabolic Syndrome.
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